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What healthcare funders want from competition inquiry

The Health Funders Association (HFA) is hopeful that a new report into the private healthcare sector‚ which will be released on Thursday‚ will serve the best interests of all South Africans.

The Health Market Inquiry (HMI) is a detailed report conducted by the Competition Commission of SA. According to the commission‚ it is a general investigation into the state of competition in the industry. The commission initiated the inquiry because it had reason to believe there were features of the sector that prevented‚ distorted or restricted competition.

The HFA‚ which represents a collective membership base of 53% of SA’s medical scheme principal members‚ was among the organisations that made submissions to the inquiry during January and February this year.

Lerato Mosiah‚ CEO of the association‚ said on Wednesday that she hoped the HMI would recommend interventions that would ensure the industry remained viable in support of universal healthcare for all South Africans. "These could include a mechanism for negotiating doctors’ and hospital charges more effectively‚ and mandatory medical scheme membership for people earning above a certain threshold."

Commenting on the recently released Medical Schemes Amendment Bill‚ which looks to stop co-payments on certain benefits for medical aid members‚ Mosiah said these provisions in isolation had the unintended consequence of threatening the sustainability of medical schemes.

"While we welcome dialogue in the sector‚ it is critical that it takes into consideration the broader picture and context‚" she said, noting that it was important to understand that medical schemes used risk-management measures to ensure they remained viable.

"Tampering with these limited measures in isolation would accelerate the erosion of reserves and leave medical schemes with very few options to maintain sustainability."